A 39-year-old woman with hypertension and radicular chest wall pain was found to have the lesion seen on chest radiograph (Fig. 63-23). The following is/are true statement(s):

d. A neurosurgical consultation should be obtained 

e. Vasoactive intestinal polypeptide level elevation suggests a ganglioneuroma

The posterior mediastinal location of the tumor is most indicative of a neurogenic tumor while teratomas are characteristically found in the anterior mediastinum. Neurogenic tumors can undergo malignant degeneration and should be resected, particularly in this symptomatic patient even if known to be present for years. The radicular pain suggests the possibility of intraspinous extension of the tumor, and therefore a neurosurgical consultation is appropriate. Both urinary vanillylmandelic acid elevation and vasoactive intestinal polypeptide can be produced by ganglioneuroma but would not be characteristic of a paraganglioma.